Stress fracture of the 5th metatarsal always causes pain in the foot. It is the reason that people go to see a doctor. Aanamnesis, anatomical localization of pain and X-ray are very much needed to get to the right diagnosis. Do you know anything about a 5th metatarsal fracture or have you even suffered it?
What is a stress fracture of the 5th metatarsal?
A synonym for the stress fracture of the foot is overload fracture. Repeated loads on a specific areas of the foot with slightly smaller forces, but persistent enough to cause injury, a stress fracture can occur. What is more, these long-lasting low forces can cause the same damage as a one-time strong force.
Healthy bone and pathologically altered bone
We must distinguish between two different types of fractures. Some fractures can occur on physiologically normal bones and some on pathologically altered bones due to other causes (osteoporosis, arthritis, diabetes).
The problem of pathological fractures is in the structure of the bone, as elasticity and mineralization may be reduced. Bones like this are not normally durable due to the disease state and fractures can occur at completely normal loads.
In physiologically normal bones, the most common stress fractures are on the feet, as the greatest force acts on them. This for example happens when we are running, landing, stopping quickly and changing direction.
5th metatarsal stress fracture is also known as a marching fracture. Same injuries were recognised in soldiers due to repeated walking in hard footwear.
Risk factors – stress fracture of the foot
Risk factors for stress fractures caused on healthy bones are:
- progressive overload
- inappropriate footwear
- inappropriate running surface
- anatomical abnormalities (high or low arch of the foot, differences in leg length, external rotation of the hip, hallux valgus deformity of the thumb)
- hormonal changes especially in women
- previous surgeries
Foot fracture – base of the 5th metatarsal
Usually foot fractures in which the bone fragment has moved out of its position require surgical treatment.
Surgical treatment leads to faster fracture healing and into a better function of the foot.
How stress fractures are going to be treated (surgically or conservatively) is doctor’s choice. Often stress fractures of the foot are treated conservatively.
Physiotherapy after stress fracture of the base of the 5th metatarsal
In the first four weeks doctor usually prescribes complete relief of the foot and walking with the help of crutches. Pacient should rest with the leg raised as often as he can. The patient may also take painkillers.
After suspension of immobilization, exercises come first. Pacient begins to implement specific exercises, that do not cause direct pressure on the foot, into everyday routine. Exercises should also have an antigravity effect on the foot (swimming, cycling, active exercises to strengthen the muscles of the ankle, foot, toes …).
It is necessary to add physiotherapeutic support equipment, as healing without it would take much longer than usual.
Usually used are:
- magnetic therapy to heal bone structures,
- ultrasound therapy or Tecar therapy for speeding up soft tissue healing,
- anti-inflammatory medium frequency electrotherapy.
Chronically inflamed tendon is typical for this injury. We are talking about peroneus longus muscle, which attaches to the bone in this area.
Pain can persist for a little longer due to fiber damage or be present even when the bone has healed. We need to add the body weight to the foot gradually.
Rehabilitation process must always adjust individually. It also depends a lot on size and location of the fracture.
Returning to sports activity is possible about 3-6 months after the injury (when the bone is completely healed and the activity is possible without pain).
The period of time varies the size of the damage and the proper process of healing. It may happen that the stress fracture doesn’t heal well and the recovery time extends to several months.